Moreover, in an intervention study of RIPerC in 30 patients with rheumatic valve disease who underwent double valve (mitral and aortic valve) replacement surgery, RIPerC had a protective effect against ischemia–reperfusion injury on the myocardium, and Bcl-2 expression in harvested atrial myocardial tissue was increased, indicating that apoptosis of the atrial myocardium was inhibited27. This evidence concerns the gene BCL2 and rheumatic disorder.